Dr. Tony Yuan checks Atzhiry Perez, 7, at the St. Rose Hospital emergency room on Thursday, March 15, 2012. St Rose Hospital in Hayward, Calif., is in dire financial straits, the charity hospital treats anyone who walks in the door, regardless of whether they have insurance. Alameda County, Kaiser, Washington Hospital in Fremont and others are now cobbling together emergency funding to keep the place open.

Photo: Carlos Avila Gonzalez, The Chronicle

Dr. Tony Yuan checks Atzhiry Perez, 7, at the St. Rose Hospital...

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St. Rose Hospital in Hayward, Calif., shown here on Wednesday, March 14, 2012, is in dire financial straits. The charity hospital treats anyone who walks in the door, regardless of whether they have insurance. Alameda County, Kaiser, Washington Hospital in Fremont and others are now cobbling together emergency funding to keep the place open.

Photo: Carlos Avila Gonzalez, The Chronicle

St. Rose Hospital in Hayward, Calif., shown here on Wednesday,...

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Nurses, Jeanette Parker, left, and Mari Hope Medenceles, right, go over patient charts in the ICU at St Rose Hospital in Hayward, Calif., on Wednesday, March 14, 2012. The hospital is in dire financial straits. The charity hospital treats anyone who walks in the door, regardless of whether they have insurance. Alameda County, Kaiser, Washington Hospital in Fremont and others are now cobbling together emergency funding to keep the place open.

Photo: Carlos Avila Gonzalez, The Chronicle

Nurses, Jeanette Parker, left, and Mari Hope Medenceles, right, go...

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Pediatric nurses, Nathalie Nguyen, left, and Kelli Murphy, right, discuss a patient's status at St Rose Hospital in Hayward, Calif., on Wednesday, March 14, 2012. The hospital is in dire financial straits. The charity hospital treats anyone who walks in the door, regardless of whether they have insurance. Alameda County, Kaiser, Washington Hospital in Fremont and others are now cobbling together emergency funding to keep the place open.

Photo: Carlos Avila Gonzalez, The Chronicle

Pediatric nurses, Nathalie Nguyen, left, and Kelli Murphy, right,...

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Brian O'Donahue, a CT Technologist at St Rose Hospital in Hayward, Calif., checks on a patient's CT scan on Wednesday, March 14, 2012. The hospital is in dire financial straits. The charity hospital treats anyone who walks in the door, regardless of whether they have insurance. Alameda County, Kaiser, Washington Hospital in Fremont and others are now cobbling together emergency funding to keep the place open.

"St. Rose provides a critical safety net for thousands of people in Alameda County," said Ruben Briones, chief of staff to county Supervisor Nadia Lockyer, whose district includes St. Rose. "It's very, very important we keep this hospital open."

St. Rose was opened in 1962 by the Sisters of St. Joseph of Wichita, Kan., a Catholic order of nuns whose mission is, among other things, to provide health care services to the poor.

"Our mission is to treat any patient who shows up, regardless of their ability to pay," said the hospital's longtime chief executive, Michael Mahoney. "Our only expectation is that we treat everyone who comes here - no matter who they are - with the same respect and high-quality services we would want for ourselves."

Lowest income

The hospital has managed to do that for decades. It sees 35,000 emergency patients a year and admits about 9,500. Most patients come from southern Alameda County, but some come from as far away as Richmond.

St. Rose and Highland Hospital, a county facility in Oakland, serve more uninsured people than any other hospitals in Alameda County.

At St. Rose, only 10 percent of the patients have private insurance. Seventy-seven percent have either Medi-Cal or Medi-Care, which reimburse the hospital a fraction of the actual treatment costs, and 13 percent have no coverage at all.

St. Rose has been able to survive by having only a few managers, almost no marketing or advertising and few expensive offerings like open heart surgery. Patients who need those services are referred elsewhere.

It excels in services most in demand among its patients, such as pediatrics, prenatal and obstetrics, and heart attack treatments. The 217-bed hospital delivers 1,300 babies a year, more than much-larger Highland.

But as health care costs have soared, the hospital's bare-bones economic model eventually collapsed. In 2005 the Sisters of St. Joseph decided to sell the facility, and when no buyer came forward, it became an independent nonprofit, one of the only free-standing hospitals in the Bay Area.

Struggle to stay open

Since then, its board has been looking for options to keep the hospital open. It not only serves a wide swath of uninsured patients, it will also be the only hospital in Hayward after Kaiser relocates to San Leandro.

The pending agreement with Washington Hospital, a public facility, is the best possible outcome for St. Rose and the community, Mahoney said.

The move will allow St. Rose to cut costs by consolidating some services with Washington Hospital. It will also save other hospitals from absorbing the thousands of uninsured patients now seen at St. Rose.

The county paid for the St. Rose bailout with funds from a legal settlement with tobacco companies.

"It's clearly the right thing to do," he said. "St. Rose would become a public entity, which keeps the community in control."

Deal in the works

Alameda County and Washington Hospital officials are working on an agreement to run St. Rose, which the supervisors are expected to approve in early April.

"We feel the closing of St. Rose would be an extraordinary public health and safety crisis," said Kimberly Hartz, associate administrator at Washington Hospital. "It's not just a Washington issue, it's a whole Alameda County issue."

Hayward Mayor Mike Sweeney said he was relieved a plan appears in place to keep open the hospital, which is also one of the city's largest employers.

"It would be tragic if St. Rose had to close," he sad. "It's great to see folks in the broader health care community work together to keep that hospital afloat."